A health care provider has charged more than what is allowed by a third-party payer. which would most likely be the result?
Answers
(C) Provider would get the typical payment instead of what was charged" is most likely be the result in the situation where a health care provider has charged more than what is allowed by a third-party payer.
MCOs have the right to withhold payment from healthcare providers whose expenses are higher than anticipated. Therefore, it is most likely that the supplier will get the indicated amount rather than what was charged, at least on the first occasion.
The question of who will pay for your patients' care is generally not on your mind throughout residency. Once you begin working as a practitioner, it's critical to comprehend who the payers are.
Since the American healthcare system mainly depends on third-party payers, it's common that your patients don't foot the majority of their medical expenditures. Commercial insurers and the federal and state governments are examples of third-party payers.
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Question Correction:
A health care provider has charged more than a managed care organization (MCO) typically pays for a procedure. Which of the following would most likely be the result?
a. Provider may be removed from the MCO's list of approved providers.
b. The MCO will re-examine the payment for that procedure.
c. Provider would get the typical payment instead of what was charged.
d. The MCO would be forced to increase its typical payment for that procedure.
Related Questions
How is an allergen different from a pathogen
Answers
Answer:
Whereas pathogens grow and multiply within their host, causing symptoms of illness, allergens pose no such threat. However, the allergic immune system silently reacts as if a pathogen were present, memorising it for subsequent encounters.
Explanation:
Allergens affect only those that have sensitivities, whereas pathogens affect anyone who comes in contact and is infected by them.
Allergens are substances that lead to allergic reactions or sensitives in certain individuals.
Pathogens are substances that infect and affect any individual that comes in contact with them.
In cases of similarity, we can see that both the pathogen and allergen proteins elicit immune activation, with the outcome of immune agitation depending on the pathogen strain, allergen exposure duration, and host factors.
Examples of some food allergens are milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat, and soybeans.
Examples of some pathogens are bacteria, fungi, protozoa, worms, viruses, and even infectious proteins called prions.
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A 45-year-old female was the unrestrained passenger of a small car that rear-ended another vehicle at a moderate rate of speed. She is conscious and alert, but complains of pain to both of her knees. There is visible damage to the dashboard on the passenger's side of the vehicle. In addition to fractures or dislocations of the knees, you should be MOST suspicious for:_______.
Answers
She is conscious and alert, but complains of pain to both of her knees. There is visible damage to the dashboard on the passenger's side of the vehicle. In addition to fractures or dislocations of the knees, you should be most suspicious for posterior hip dislocation. Option B is the correct answer.
Hip dislocations are divided into groups based on the relationship between the fracture and the position of the displaced femoral head. The most typical kind of dislocation is a head that is positioned posteriorly. Option B is the correct answer.
Hip dislocations are a medical emergency that call for immediate reduction, or re-insertion of the femoral head into the acetabulum. With the use of techniques like applying traction to the thighbone in the direction of the dislocation, the femoral head is routinely reduced back into the hip socket while the patient is sedated and without surgery. A hip dislocation occurs when the pelvis (hip bone) and femur (thighbone) separate. Particularly, it occurs when the femur's ball-shaped head separates from its cup-shaped socket in the hip bone.
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The complete question is, "A 45-year-old female was the unrestrained passenger of a small car that rear-ended another vehicle at a moderate rate of speed. She is conscious and alert, but complains of pain to both of her knees. There is visible damage to the dashboard on the passenger's side of the vehicle. In addition to fractures or dislocations of the knees, you should be MOST suspicious for:
A. a thoracic spine fracture.
B. posterior hip dislocation.
C. fracture of the tibia or fibula.
D. anterior hip dislocation."
Air pollution:
1. What is the controversy or debate surrounding this social health concern?
2. What are your opinions about this social health issue?
Answers
Answer:
Explanation:
some organizations are trying to help reduce air pollution, while other people with more power just dont care. my opinion about this is taht we need to be more mindful, because if it gets out of hand we are going to leave a big mess for the future. The future genaration does not deserve punishment for something that people before them started.
What are some home remedies for a broken hand?
Answers
Control any bleeding.
Apply ice to the injured area to ease pain and reduce swelling.
Remove any jewelry right away. ...
Support a deformed hand on a pillow.
Take an over-the-counter pain reliever like acetaminophen or ibuprofen.
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I really suggest you go to a doctor if you have broken your arm. Failing to do so can result in your arm being in more pain and it could heal the bone wrong.
Which statement BEST describes the joy and benefits of playing an individual sport?
Answers
Playing individual sports helps a person advance mental and physical skills and improves overall health and fitness. -BEST describes the joy and benefits of playing an individual sport.
Playing individual sports helps a person advance mental and physical skills and improves overall health and fitness. Thus, the correct option is C.
What are individual sports?Individual sports can be defined as those sports where only one individual competes with each other in opponent teams from both the sides. It includes the sports like boxing, golf, wrestling, and tennis, etc.
Individual sports prevents the interference of others in the game. A person has to play according to his/ her strengths and weaknesses.
Playing individual sports helps a person in advancing the mental and physical skills and improves the overall health and fitness of an individual.
Therefore, the correct option is C.
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Your question is incomplete, most probably the complete question is:
Which statement BEST describes the joy and benefits of playing an individual sport?
A. Playing individual sports is more demanding, so the participant can eat more.
B. Individual sports are better because there are no teammates to have to consider.
C. Playing individual sports helps a person advance mental and physical skills and improves overall health and fitness.
D. A person who participates in an individual sport can be weak in some aspects of the sport because there is no accountability to team members.
Which position correctly describes the human anatomical position
Answers
Answer:
An erect posture facing forward, with the arms at the sides and the palms facing front.
Briefly tell about one treatment option for depression
Answers
Answer:
One treatment option would be to see therapist to talk about your problems or why you may be depressed or you could do like me and just take 500 mg of zoloft
Explanation:
What helps regulate body processes
Answers
Answer: Es la suma de todos los procesos químicos que se producen en el cuerpo y que se pueden dividir en catabolismo, ruptura de moleculas complejas en componentes simples y anabolismo, la construcción de sustancias químicas complejas a partir de elementos más pequeños y simples)
Explanation:
what client is being treated with a typical antipsychotic?
Answers
A client with schizophrenia is typically treated with a typical antipsychotic. Antipsychotics are medications used to treat psychotic disorders such as schizophrenia and delusional disorders.
Antipsychotic drugs reduce or eliminate symptoms such as delusions, hallucinations, and disordered thinking by altering the function of brain neurotransmitters. In this case, a client with schizophrenia is typically treated with a typical antipsychotic medication.
The effectiveness of these medications is based on their ability to decrease positive symptoms such as hallucinations, Antipsychotic drugs reduce or eliminate symptoms such as delusions, hallucinations, and disordered thinking by altering the function of brain neurotransmitters. delusions, and disorganized speech while also reducing negative symptoms such as emotional withdrawal and apathy.
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Jessy manages a team of editors for a monthly medical publication. Her team finishes editing a challenging issue days ahead of schedule, so Jessy takes her team out to lunch. Jessy is showing her
Answers
Team leadership
Answer:
D - appreciation
Explanation:
good luck!
Which area is responsible for detailed, color vision?
Answers
find the value of given expression
\( \sqrt{898 \times 898} \)
Answers
You can write it as √898^2, than cancel √ and ^2
What is the: a. proxy for temperature (careful, trick
question), b. length of the time series and c. pattern of change in
figure 3?
A:
B:
C:
Answers
a. Proxy for temperature: The graph shows the data of 18O from a stalagmite in Cave M. Since temperature and 18O are inversely proportional, it can be inferred that the 18O data serves as a proxy for temperature.
b. Length of time series: The length of the time series presented in Figure 3 is 1,200 years. c. Pattern of change: The graph shows a gradual decrease in temperature from 200 BCE until about 900 CE, with a low point at around 400 CE. The temperature then increases, peaking at around 1200 CE, before decreasing again to the end of the graph at around 1200 CE.
Length of time series: The length of the time series presented in Figure 3 is 1,200 years. Pattern of change: The graph shows a gradual decrease in temperature from 200 BCE until about 900 CE, with a low point at around 400 CE. The temperature then increases, peaking at around 1200 CE, before decreasing again to the end of the graph at around 1200 CE. However, it is important to note that the y-axis is inverted, meaning that the temperature decreases as the values on the y-axis increase.
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I was making Pancakes, and I made a very thin pancake and cooked for over 3 minutes on each side, would it be considered raw?
(The heat was in between 3 and 4)
Answers
Answer:
No it would not be considered raw
Explanation:
6. Which of the following is a disadvantage of single living?*
1Having time to do what a person wants.
2Gaining self-confidence through emotional and financial independence.
3Being mobile to easily make a career change.
4Being viewed as irresponsible or self-centered.
Answers
Answer:
The correct answer to this question is 4 Being viewed as irresponsible or self-centered.
Explanation:
This is because all of the other ones are advantages and are good but the last one is a disadvantage and is bad. I hope that I helped. Please mark me brainliest...?!!!
Answer ALL the questions in this section.
NOTE: All 4 questions are related to the case study.
Overview Community Medical Associates (CMA) is a large urban health care system with two hospitals, 25 satellite health centers, and 56 outpatient clinics. CMA had 1.5 million outpatient visits and 60,000 inpatient admissions the previous year. Long patient waiting times, uncoordinated clinical and patient information, and medical errors plagued the system. Doctors, nurses, lab technicians, managers, and medical students in training were very aggravated with the labyrinth of forms, databases, and communication links. Accounting and billing were in a situation of constant confusion and correcting medical bills and insurance payments. The complexity of the CMA information and communication system overwhelmed its people. Today, CMA uses an integrated operating system that consolidates over 50 CMA databases into one. Health care providers in the CMA system now have access to these records through 7,000 computer terminals. The next phase in the development of CMAs integrated system was to connect it to suppliers, outside labs and pharmacies, other hospitals, and to doctor's home computers, that is, the entire value chain. The case allows the students to apply lean principles to a large and complex health care network and think about the nature of the value chain. This case is best assigned to individual students or student teams and the class discussion can range from 20 to 30 minutes depending on what the instructor wants to emphasize. Like many cases in the OM text, we try to get students out of the goods-producing factory and into a serviceproviding organization.
Elaborate on how CMA used the four principles of lean operating systems to improve performance.
Answers
The case study describes how Community Medical Associates (CMA) used the four principles of lean operating systems to improve performance. These principles are Identify value from the customer's perspective, Map the value stream, Create flow and Pursue perfection.
CMA recognized the need to streamline and improve the patient experience. They identified the value from the customer's perspective as reducing waiting times, improving coordination of clinical and patient information, and minimizing medical errors. CMA realized that their information and communication system was overly complex and caused frustration among their staff.
CMA aimed to create a smooth flow of information and processes within their system. They consolidated over 50 databases into one integrated operating system, allowing health care providers to access patient records through computer terminals.CMA recognized that achieving perfection is an ongoing journey. They aimed to continuously improve their processes, systems, and overall performance. By connecting their integrated system to suppliers, labs, pharmacies, hospitals, and doctors' home computers, CMA aimed to further enhance the value chain and achieve a more seamless and efficient healthcare network.
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What do calories measure? mass energy sugar weight
Answers
Answer:
I believe the answer is energy.
Explanation:
None.
Answer: Energy Hope this helps and can i get Brainliest plsss :)
Explanation:
excessive intake of nonheme iron interferes with absorption of which mineral by an unknown mechanism?
Answers
Excessive intake of nonheme iron interferes with the absorption of zinc by an unknown mechanism.
What is nonheme iron?Nonheme iron refers to the iron present in the plant foods we consume. It is less bioavailable than heme iron found in meat, poultry, and fish and is often dependent on dietary factors such as vitamin C and other factors for absorption.
What is the function of zinc in the human body?Zinc is a mineral required for the formation of DNA, protein, and insulin in the body. Zinc is also essential for maintaining a healthy immune system, wound healing, and normal growth and development in children.
Zinc is found in a variety of foods, including meat, poultry, fish, and whole grains. Zinc is a trace element, which means that it is required in small quantities for proper body function. Excessive intake of nonheme iron has been shown to interfere with the absorption of zinc.
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Briefly explain any seven measures to minimize the effects of rapid population growth.
Answers
2. Education: Providing education to girls and women can help reduce fertility rates and promote family planning.
3. Healthcare: Improving access to healthcare can help reduce infant and child mortality rates and increase life expectancy, which can promote smaller family sizes.
4. Economic development: Reducing poverty and increasing economic opportunities can help reduce fertility rates as families have fewer children when they can afford to provide for them.
5. Urbanization: Encouraging urbanization can help reduce fertility rates as people tend to have smaller families in urban areas.
6. Conservation: Promoting conservation and sustainable use of resources can help reduce the burden on natural resources and reduce the impact of population growth on the environment.
7. Immigration policies: Implementing immigration policies that consider the impact on population growth can help reduce the strain on resources in the host country.
How does marijuana affect the pharynx ?
Answers
This question is for the ladies
what color should my cycle (blood) be
Answers
Answer:
Most should be red, but some brown at the start or end is normal.
Explanation:
Most of it should be bright red like normal blood, but it can be brown or brown-ish at the start or end. At the start means it didn't get it all out of your uterus from last cycle. At the end means the lighter last bit is taking longer to come out than the heavier stuff.
Answer:
Fresh blood at the beginning of your stuff is usually bright red. A heavy flow could be darker, especially with clots. Rusty brown blood is older; which you'll typically see toward the end of the week because the air has had a chance to react with it. Pinkish is probably just a light. To make it go faster drink water, exercise lightly, get the right nutrients making sure you up vitamin C.
Please help me its urgent!!!!!
Answers
Answer:
imma say b if not do a sorry if its incorrect plz forgive me man i tried
Explanation:
when are fitness logs due
Answers
Answer:
When your teacher assigns them to be due.
Name and explain the socio-economic implications of
poor health care system in a nation.
Answers
A poor healthcare system in a nation can have significant socio-economic implications. First, it can lead to a reduction in the productivity of the workforce. When people are not healthy, they cannot perform at their best, which can result in lower levels of productivity in the workplace.
Second, a poor healthcare system can have a significant impact on the economy of a nation. The cost of treating diseases and illnesses can be high, and in many cases, people who cannot afford to pay for healthcare must seek alternative treatment options or go without treatment. This can lead to a cycle of poverty, where people are unable to access healthcare services and, as a result, their health deteriorates further.Third, a poor healthcare system can also have a significant impact on the education sector. When children are not healthy, they are likely to miss school, which can result in lower levels of educational attainment. This, in turn, can have long-term implications for the economic and social development of a nation.
In conclusion, a poor healthcare system can have significant socio-economic implications for a nation. It can result in lower levels of productivity, a cycle of poverty, and lower levels of educational attainment. Therefore, it is essential for governments to invest in healthcare systems to ensure that all individuals have access to proper healthcare facilities.
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3. What is TRUE about people throughout the world living with HIV?
Almost everyone who needs anti-HIV medications has access to them.
There are more than 35 million of them.
They are mostly gay men and IV drug users.
Their life expectancy is very short.
Answers
Answer:
There are more than 35 million of them.
Explanation:
People with HIV can manage their illness and live a long time by taking the proper medications. HIV affects men, women, and children; some HIV positive people are gay men or IV drug users. Anti-HIV medications are expensive and not available to all who need them.
I also just finished the test ! :)
There are more than 35 million of them, is TRUE about people throughout the world living with HIV. Hence, option B is correct.
What is HIV positive?If HIV is not treated, it often advances to AIDS in 8 to 10 years. When AIDS strikes, your immune system has been badly damaged. You'll be more prone to infections that someone with a robust immune system wouldn't normally contract. These are opportunistic tumours or opportunistic infections.
Although there is presently no cure for HIV, there are highly efficient pharmacological therapies that allow the majority of those infected to live long, healthy lives. Most HIV-positive individuals will not have any AIDS-related illnesses and will live relatively normal lives if they receive an early diagnosis and adequate therapies.
Thus, option B is correct.
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All of the following are best practices for safe temperature control for food except:
a. Regularly monitoring and recording temperatures
b. Keeping hot food above 140°F (60°C)
c. Rapidly cooling leftovers before refrigerating
d. Storing raw and cooked foods separately
Answers
All of the following are best practices for safe temperature control for food except storing raw and cooked foods separately. The option (d) is correct.
Explanation: Safe temperature control of food is a crucial practice to minimize the risk of bacterial growth, food poisoning, and foodborne illnesses. Here are some of the best practices for safe temperature control for food:
Regulate temperatures in refrigerators and freezers frequently. Keep them within the range of 0°F to 40°F (-18°C to 4°C) for refrigerators and -10°F to 0°F (-23°C to -18°C) for freezers. Monitor and document the temperature of cooked and raw foods regularly. Keep the hot food at or above 140°F (60°C) and cold food at or below 40°F (4°C).Rapidly cool leftovers to below 40°F (4°C) before storing them in the refrigerator, and use them within two to three days.
Store raw and cooked food separately, with raw meat on the bottom shelf to avoid cross-contamination. Consequently, from the given options, storing raw and cooked foods separately is not a safe temperature control practice. Thus, the option (d) is correct.
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what is life? and does life have a purpose
Answers
Explanation:
English
What can you do with a personal vision statement
after you write it?
Answers
Answer: You can use a personal vision statement as a guide to:
1. Determine a career to pursue.
2. Making important life decisions.
3. Planning how you'll accomplish certain goals.
And most importantly, realizing your life dreams and wants.
hello, 3 questions um try to answer all but if you only know one that's cool,
1. why is it helpful to have a " second pair of ears "
2. why could it be beneficial to get a second opinion after receiving a serious diagnosis
3. a fitness expert will take into account your time _____
Answers
Answer:
1 is so that you could hear better. 2 is so that it is not wrong and one opinion may be different from everyone elses.
Explanation:
Answer:
1. to hear twice as good
2. to make sure that the diagnosis you received is accurate
3. management?
...
hope you enjoy this photo of The Dahli...please dont flag me c:
The pineal gland makes melatonin to help with sleep regulation. A.TRUEB.FALSE
Answers
It is True that the pineal gland makes melatonin to help with sleep regulation.
The hormone melatonin is secreted by your pineal gland, a tiny endocrine gland in the middle of your brain that helps keep your body's circadian rhythm in check.
Your pineal gland, also known as the epiphysis cerebri or the pineal body, is a small gland in your brain beneath the corpus callosum's back. Melatonin is produced by this component of your endocrine system. Melatonin is produced by your pineal gland, whose primary function is to assist in regulating the circadian cycle of sleep and wakefulness.
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